A new award of $1.5 million over five years to RICARES positions Rhode Island’s recovery advocacy organization to expand its peer recovery efforts, a cornerstone of any effort to reduce the number of overdose drug deaths in the state.

The questions to be asked

What can be learned from RICARES in developing peer recovery networks for COVID-19 pandemic survivors in a time of severe economic and social disruption? How can efforts underway to develop a long-term health plan for Rhode Island incorporate peer recovery as integral part of patient advocacy? When will there be a better dataset built to integrate the diseases and deaths of despair – from alcohol, suicide and drugs – with economic conditions? What kinds of investments need to be made in bottom-up innovation at the community level as a source of future economic prosperity?

Under the radar screen

In a recent op-ed in The New York Times, Anne Case and Angus Deaton, the authors of the recent book, “Deaths of Despair and the Future of Capitalism,” spoke in hard terms about the current crisis in health care, accentuated by the COVID-19 pandemic. “The American health care industry is not good at promoting health,” they wrote. “But it excels at taking money from all of us for its benefit. It is an engine of inequality.”
Case and Deaton acknowledged that now is a difficult time to talk about the costs of health care, when doctors and nurses are risking their lives to fight the virus. Still, they argue that the pandemic “provides an opportunity for systemic change.” They continued: “The United States spends more than any other nation on health care, and yet we have the lowest life expectancy among rich countries.”
In their op-ed, Case and Deaton attempted to make the case that “employer-based health insurance is a wrecking ball, destroying the labor market for less-educated workers and contributing to the rise in ‘deaths of despair.’”
The question is: how do we begin to have this critical conversation in the midst of pandemic? Perhaps we can learn from listening to the voices of peer recovery advocates.

PROVIDENCE – If you were to write a murder mystery story set in our current times of epidemic and pandemic, one might be tempted to give it a catchy title with a double meaning, such as “Accentuating the Positive.” And, if the plot was dark enough to be made into a movie, the soundtrack could feature an adaptation of jazz pianist Bill Evans tunes, a musician whose career was scored by struggles with addiction and recovery.

On Wednesday, April 15, the R.I. Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals put out a news release that attracted scant attention, given the focus on the coronavirus pandemic, with the headline “RI Overdose Deaths Down in 2019.”

The news release began: “Rhode Island for the third consecutive year is reporting a reduction in accidental drug overdose deaths occurring in the state.”

The release continued: “The state saw 308 accidental drug overdose deaths during 2019 – down from 314 during 2018, and down from a high of 336 in 2016. Since 2016, Rhode Island has seen an 8.3 percent reduction.”

[By comparison, in the last six weeks, as of Friday, April 17, there have been 137 deaths caused by the COVID-19 virus, according to the R.I. Department of Health.]

The sunny side of the streetNo doubt, it is difficult to articulate the “positive reframe” to the fact that more than 300 Rhode Islanders have died each year for the last four years from drug overdoses, despite the enormous efforts undertaken and resources devoted by the state to address the continuing epidemic. Still, Kathryn Power, the acting director at R.I. BHDDH, made an earnest attempt.

“We are pleased to see that the numbers are down for the third straight year. At the same time, we know that we are still fighting an overdose epidemic, and as we grapple with the coronavirus today, it’s more important than ever that we keep our actions focused and connect Rhode Islanders with critical resources and support,” Power said in the news release.

Far from declaring victory, Power continued, “We must make sure that prevention activities are available in all our communities, make sure that treatment and recovery resources are available to all who need them, and make sure that people acknowledge that addiction is a disease and recovery is possible.”

In talking about the grim if not perverse death toll from drug overdoses, the news release also mentioned, for the first time, that the opioid epidemic was not just about opioids, saying that “alcohol and cocaine were also major contributors.”

Bigger newsThe bigger news from last week [which ConvergenceRI is pleased to break] is that RICARES, a peer-led recovery advocacy and harm reduction organization now in its 21st year, was awarded a five-year, $300,000-a-year grant from the federal Substance Abuse and Mental Health Services Administration [SAMHSA] to support its Project Recovery 2.0 program, offering a wide range of peer recovery services throughout Rhode Island.

The award recognizes the expertise in ongoing peer recovery work that RICARES has cultivated. “The RICARES staff has worked tirelessly over the last three years to build an agency that is community-driven, responsive, and recognized for our expertise,” said Executive Director Monica Smith. The award, she continued, will allow RICARES to continue to build on that momentum.

RICARES was one of only six programs in the nation to be awarded the grant. The others include: recovery community organizations in Seattle, Wash.; El Paso, Texas; Detroit, Mich.; Birmingham, Ala.; and the Recovery Program at Steppingstone, Inc. in Fall River, Mass.

As an integral part of Recovery 2.0, RICARES will be partnering with a number of local organizations to provide peer recovery support services. They include: Project Weber/Renew; Parent Support Network of RI; Rhode Island Hospital; Access to Recovery; VICTA; the RI Rally4Recovery Coalition; and the Health Equity Zone programs in which Thundermist Health Center serves as the backbone agency.

In particular, the support for Project Recovery 2.0 will enable RICARES to build out its network of community relationships and new initiatives. They include: a family support program for parents and grandparents of people with addictions; assistance to people in recovery housing who are in financial difficulty; an enhanced relationship with recovery community centers; and strengthening linkages with peer recovery supports and hospitalized, acute care in-patient clients.

“We define our mission as situated at the intersection of social justice, trauma, and recovery,” according to one RICARES staff member. “We take our slogan from the movement of people with AIDS: ‘Nothing about us without us!’

Equally important is the focus on the voices of people in recovery being heard and respected. “The voices of people in recovery, and people who use drugs, must be at the center of every discussion of addiction and recovery,” as one RICARES staff member said.